CURRENT THERAPY IN THE MANAGEMENT OF HETEROTOPIC OSSIFICATION OF THE ELBOWA Review with Case Studies1
作者:
Bruce Ellerin,
David Helfet,
Suhrid Parikh,
Robert Hotchkiss,
Nachum Levin,
Lourdes Nisce,
Dattatreyudu Nori,
Janaki Moni,
期刊:
American Journal of Physical Medicine and Rehabilitation
(OVID Available online 1999)
卷期:
Volume 78,
issue 3
页码: 259-271
ISSN:0894-9115
年代: 1999
出版商: OVID
关键词: Elbow;Heterotopic Ossification;Radiation Therapy;Diphosphonates
数据来源: OVID
摘要:
Heterotopic ossification, or the appearance of ectopic bone in para-articular soft tissues after surgery, immobilization, or trauma, complicates the surgical and physiatric management of injured joints. The chief symptoms of heterotopic ossification are joint and muscle pain and a compromised range of motion. Current therapies for prevention or treatment of heterotopic ossification include surgery, physical therapy, radiation therapy, and medical management. Unlike heterotopic ossification of the hip, heterotopic ossification of the elbow has not been extensively investigated, leaving its optimal management ill-defined. To remedy this deficiency, we review risk factors, clinical anatomy, physical findings, proposed mechanisms, and current practice for treatment and prevention of heterotopic ossification. We then consider and draw conclusions from four cases of elbow injury treated at our institutions (three complicated by heterotopic ossification) in which treatment included surgery, radiation therapy, physical therapy, and medical therapy. We summarize our institutional practices and conclude with a call for a randomized clinical trial to better define optimal management of heterotopic ossification of the elbow.
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